声带息肉和Reinke水肿细胞外基质蛋白mRNA表达

mRNA expression of extracellular matrix proteins of vocal fold polyps and Reinke edema

目的探讨声带息肉和 Reinke 水肿中,声带固有层细胞外基质主要成分 mRNA 表达的变化,为阐明疾病发病机制提供依据。方法应用逆转录-聚合酶链反应检测手术切除标本(声带息肉12例,Reinke 水肿2例,5例行全喉切除而声带未受肿瘤侵犯的声带作为正常对照),细胞外基质中与胶原纤维、弹性纤维和透明质酸有关的9种蛋白的 mRNA 表达。结果声带息肉与对照声带比较,胶原酶 mRNA 表达下降,纤连蛋白 mRNA 表达升高,而纤调蛋白 mRNA 表达下降,差异均有统计学意义(P 值均<0.05);赖氨酰氧化酶、透明质酸合成酶在病变和对照组织 mRNA 表达量差异无统计学意义(P 值均>0.05);前弹性蛋白原、透明质酸酶、弹性蛋白酶在病变组织 mRNA 阳性表达率低于对照组织;前胶原Ⅰ在所有组织中均无表达。声带 Reinke 水肿组纤连蛋白表达量接近息肉组,纤调蛋白表达量接近对照组,因样本量小未做统计学分析。结论纤连蛋白和纤调蛋白是参与声带息肉病理过程的两种细胞外基质成分。反复用声造成损伤以及声带对损伤的修复过程可能在声带息肉发病机制起重要作用。

Objective To investigate the pathogenic mechanism of vocal fold polyps and Reinke＇s edema. Methods A reverse-transcriptase polymerase chain reaction （RT-PCR） technique was adopted, mRNA levels of 9 proteins were measured in 12 vocal fold polyps, 2 Reinke＇s edema and 5 normal vocal folds（from total larygectomy）. Results The results showed that in the vocal fold polyps, mRNA levels of collagenase and fibromodulin descended and levels of fibronectin increased （ P 〈 0. 05 ）. mRNA levels of lysyl oxidase and hyaluronic acid synathase 2 had no statistic difference between lesions and normal vocal folds（P 〉0. 05）. mRNA express of tropoelastin exon, elastase and hyaluronidase was positive in part of lesion tissue and positive in all normal vocal folds, mRNA of procollagen I was negative in both groups. In the Reinke＇s edema, mRNA express of fibronectin was close to vocal fold polyps and mRNA express of fibromodulin was close to normal vocal folds. Conclusions It was speculated phonation trauma and vocal fold restoring to trauma played an important role in pathogenic mechanism. Fibromodulin and fibronectin were two components involved in the disorders.